Read Provider Update
This monthly newsletter delivers updates on policies, changes to benefits, and other news you need to know.
- P = Professional
- B = Behavioral health
- F = Facilities
BCBSRI Update
P B F
1 Abr, 2025
The Centers for Medicare and Medicaid Services (CMS) reminds Medicare Advantage Organizations to con...
P B F
1 Abr, 2025
BCBSRI has seen an increase in claims processed by out-of-network providers or laboratories which we...
P B F
1 Mar, 2025
Upon enrollment, our members are granted certain rights – and protection of these rights – in all th...
Provider Relations
P B F
1 Abr, 2025
BCBSRI invites providers to join us on Tuesday, 8 de abril, 2025 from 10-11 a.m. for a conference call ...
P B F
1 Abr, 2025
Beginning 1 de junho, 2025, BCBSRI Provider Contact Center will implement a Claim Transaction Limit.&nbs...
P B F
1 Mar, 2025
BCBSRI invites providers to join us on Tuesday, 11 de março, 2025 from 10-11 a.m. for a conference...
Physician & Provider Call Center
P B F
1 Jul, 2023
As a reminder, there is a functionality on the BCBSRI Provider Portal that allows providers to send ...
P B F
1 Jun, 2021
Did you know our secured Physician and Provider Portal offers the following: •Check me...
Quality
P
1 Abr, 2025
The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool developed by the National Co...
P
1 Mar, 2025
The Centers for Medicare and Medicaid Services (CMS) has introduced two new Part D Star Measures for...
P
1 Fev, 2025
The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) is an industry standard survey ...
Behavioral Health
P B
1 Abr, 2025
National Alcohol Awareness Month was founded in 1987 by The National Council on Alcoholism and ...
P B
1 Abr, 2025
BCBSRI has collaborated with providers throughout Rhode Island to ensure that our members have acces...
P B
1 Abr, 2025
The BCBSRI Behavioral Health Case Management program is staffed by experienced mental health and sub...
Farmácia
P F
1 Abr, 2025
The following drugs will require PA effective 4/1/25...
P B F
1 Mar, 2025
Large Group and Small Group Markets FormularyThe information below is effective as of 1 de abril, 2025,...
P F
1 Fev, 2025
The following drugs will require authorization in 2025:Drug NameGenericCodeMedicare Effective DateCo...
Products & Benefits
P B F
1 Dez, 2019
In the large group portfolio, we will also be adding eight Network Blue New England Options plans, a...
P B F
1 Dez, 2019
Our regional BlueCHiP family is expanding in the small group market with Effective 1 de janeiro, 2020, ...
P B F
1 Dez, 2019
Effective 1 de janeiro, 2020, BCBSRI will become the insurer for all Lifespan employees. Below is a qui...
Reivindicações
P B F
1 Abr, 2024
BCBSRI is not a PPO network sharing plan. We are not allowed to price based on our participating pro...
P B F
1 Jan, 2024
BCBSRI claims department has seen an increase in claims rejecting for no eligibility because claims ...
P B F
1 Nov, 2023
If you are correcting a claim due to an audit finding, you must submit Medical Records with your cor...
Policies
P
1 Abr, 2025
Allergy Immunotherapy Injections The above referenced policy was updated to clarify that BCBSRI...
P F
1 Abr, 2025
We have completed our review of the 20 de abril25 Healthcare Common Procedure Coding System (HCPCS) cha...
P F
1 Abr, 2025
Prior authorization via web-based tool for Durable Medical Equipment (DME)Effective 1 de junho, 2025, fo...